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The patient asks the nurse what atorvastatin (Lipitor) newly prescribed will do. What's the expected outcome the nurse will describe?
- A. Decrease in sitosterol and serum cholesterol.
- B. Decrease in campesterol and LDL levels.
- C. Decrease in serum cholesterol and low-density lipoprotein (LDL) levels.
- D. Decrease in serum cholesterol only.
Correct Answer: C
Rationale: The correct answer is C because atorvastatin works by inhibiting the enzyme HMG-CoA reductase, leading to a decrease in serum cholesterol and LDL levels. This is the expected outcome that the nurse will describe to the patient. Choice A is incorrect because sitosterol is not primarily targeted by atorvastatin. Choice B is incorrect as campesterol is not a main focus of atorvastatin. Choice D is incorrect because atorvastatin also targets LDL levels, not just serum cholesterol.
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What is the responsibility of the nurse related to the patient's drug therapy? Select all that apply.
- A. Teaching the patient how to cope with therapy to ensure the best outcome.
- B. Altering the drug regime to optimize the outcome.
- C. Evaluating the effectiveness of therapy.
- D. Providing therapy as well as medications.
- E. Recommending over-the-counter medications to treat adverse effects of prescription drug therapy.
Correct Answer: A,C
Rationale: The correct answers are A and C. A nurse's responsibility related to a patient's drug therapy includes teaching the patient how to cope with therapy for optimal outcomes (A) and evaluating the effectiveness of the therapy (C). Teaching the patient ensures they understand how to take medications correctly and manage any side effects. Evaluating effectiveness allows for adjustments in the treatment plan if needed. Choices B, D, and E are incorrect. B - altering the drug regime should be done by the prescribing healthcare provider, not the nurse. D - providing therapy is beyond the scope of a nurse's responsibilities, as they focus on administering medications and supporting the patient. E - recommending over-the-counter medications falls under the purview of a pharmacist or physician, not a nurse.
A patient exhibits ptosis of both eyes and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis. The nurse understands that this patient most likely has which disorder?
- A. Myasthenia gravis.
- B. Cerebral palsy.
- C. Multiple sclerosis.
- D. Muscle spasm.
Correct Answer: A
Rationale: The correct answer is A: Myasthenia gravis. Edrophonium is a reversible acetylcholinesterase inhibitor that improves muscle strength in patients with myasthenia gravis due to its ability to increase acetylcholine levels at the neuromuscular junction. The immediate improvement of ptosis after administration of edrophonium suggests a diagnosis of myasthenia gravis, a disorder characterized by muscle weakness and fatigability. Cerebral palsy (B) is a non-progressive neurological disorder not typically associated with ptosis and not responsive to edrophonium. Multiple sclerosis (C) is an autoimmune demyelinating disorder that does not typically present with ptosis. Muscle spasm (D) does not explain the ptosis and would not improve with edrophonium.
You are writing a care plan for a patient who is taking anticoagulant. What would be an appropriate nursing diagnosis?
- A. Maintain narcan on standby.
- B. Notify the healthcare provider of any patient receiving this drug.
- C. Evaluate patient for PT for 2.5.
- D. Establish safety precautions.
Correct Answer: D
Rationale: The correct answer is D: Establish safety precautions. This is the appropriate nursing diagnosis for a patient taking anticoagulants as they are at an increased risk of bleeding. Safety precautions, such as fall prevention measures and educating the patient about signs of bleeding, are crucial to prevent complications.
A: Maintaining narcan on standby is not relevant to anticoagulant therapy as narcan is used to reverse opioid overdose, not to manage bleeding risk associated with anticoagulants.
B: Notifying the healthcare provider is important, but it is not a nursing diagnosis. It is a part of the nursing intervention to ensure appropriate management of anticoagulant therapy.
C: Evaluating the patient for PT (prothrombin time) of 2.5 is a specific laboratory value, not a nursing diagnosis. It is important for monitoring anticoagulant therapy effectiveness.
Summary: Option D is correct as it focuses on patient safety in the context of anticoagulant therapy
A patient who has recently begun taking captopril (Capoten) to treat HTN calls a clinic to report a persistent cough. The nurse will perform which action?
- A. Reassure the client that this is nothing to worry about and will diminish over time.
- B. Tell the patient to stop taking the drug immediately as this is a serious side effect of the drug.
- C. Schedule an appointment with the provider to discuss changing to an ARB.
- D. Instruct the patient to go to the emergency room immediately as this is a hypersensitivity reaction.
Correct Answer: C
Rationale: The correct answer is C. The nurse should schedule an appointment with the provider to discuss changing to an ARB (angiotensin II receptor blocker). Captopril, an ACE inhibitor, can cause a persistent cough as a common side effect due to increased bradykinin levels. Switching to an ARB, which works similarly but does not affect bradykinin levels, can resolve the cough while still effectively treating hypertension.
Explanation for other choices:
A: Incorrect. Persistent cough with captopril is not something to be disregarded as it can impact the patient's quality of life and adherence to treatment.
B: Incorrect. Stopping the medication abruptly without provider guidance can lead to uncontrolled hypertension.
D: Incorrect. A hypersensitivity reaction typically involves more severe symptoms beyond just a cough.
A patient has been taking Sertraline (Zoloft) 20mg/ml oral concentrate 1ml daily for several weeks and reports being unable to sleep well. What will the nurse do next?
- A. Ask the patient what time of day the medication is taken.
- B. Recommend asking the provider about weekly dosage.
- C. Counsel the patient to take the medication at bedtime.
- D. Suggest that the patient request a lower dose.
Correct Answer: A
Rationale: The correct answer is A: Ask the patient what time of day the medication is taken. This is because insomnia can be a common side effect of sertraline, and taking it at a different time of day may help alleviate this issue. By understanding the timing of the medication intake, the nurse can assess if adjusting the administration time may improve the patient's sleep. Option B is not directly related to addressing the sleep concern. Option C may help but does not address the timing issue. Option D is premature without assessing the current timing.